Epidemiology and Infection

Original Papers

Gastroenteritis/Food poisoning

Recurrent epidemic cholera with high mortality in Cameroon: persistent challenges 40 years into the seventh pandemic

E. J. CARTWRIGHTa1a2 c1, M. K. PATELa1a2, F. X. MBOPI-KEOUa3a4, T. AYERSa2, B. HAENKEa5, B. H. WAGENAARa5, E. MINTZa2 and R. QUICKa2

a1 Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA

a2 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA

a3 Ministry of Public Health, Yaoundé, Cameroon

a4 University of Yaoundé I, Cameroon

a5 Community Health Volunteer, Far North Region of Cameroon; United States Peace Corps, Washington, DC, USA


Cameroon has experienced recurrent cholera epidemics with high mortality rates. In September 2009, epidemic cholera was detected in the Far North region of Cameroon and the reported case-fatality rate was 12%. We conducted village-, healthcare facility- and community-level surveys to investigate reasons for excess cholera mortality. Results of this investigation suggest that cholera patients who died were less likely to seek care, receive rehydration therapy and antibiotics at a healthcare facility, and tended to live further from healthcare facilities. Furthermore, use of oral rehydration salts at home was very low in both decedents and survivors. Despite the many challenges inherent to delivering care in Cameroon, practical measures could be taken to reduce cholera mortality in this region, including the timely provision of treatment supplies, training of healthcare workers, establishment of rehydration centres, and promotion of household water treatment and enhanced handwashing with soap.

(Received February 29 2012)

(Revised November 12 2012)

(Accepted November 28 2012)

(Online publication January 10 2013)

Key words

  • Cholera;
  • diarrhoea;
  • Vibrio cholerae ;
  • water (safe)


c1 Author for correspondence: E. J. Cartwright, M.D., Emory University Division of Infectious Diseases, 49 Jesse Hill Dr., Atlanta, GA 30303, USA. (Email: ejcartwright@gmail.com)